Combination of Hyaluronic Acid and Polynucleotides Injection for the Treatment of Cheilitis Simplex

Kartika Ruchiatan, Yuri Yogya, Ilma Arifani, Reti Hindritiani, Diah Puspitosari, Trustia Rizqandaru, Srie Prihianti Gondokaryono, Pati Aji Achdiat Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran - Dr. Hasan Sadikin General Hospital, Bandung, IndonesiaCorrespondence: Kartika Ruchiatan, Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran – Dr. Hasan Sadikin General Hospital, Jl. Pasteur 38, Bandung, West Java, Indonesia, Tel +62811247932, Fax +62222032426, Email [email protected]: Cheilitis simplex is a prevalent form of cheilitis that is characterized by the presence of cracked lips, fissures, or desquamation, due to various etiologies. Utilization of “boosters” as a treatment for chapped lips has not been extensively researched. This case report aimed to describe the efficacy of lip booster injection comprising active ingredients of 1% hyaluronic acid (HA) and 1% polynucleotides (PN), with 0.3% lidocaine as anesthetic agent. A 30-year-old female patient presented with a chief complaint of dry and chapped lips that occasionally bleed. This condition had recently deteriorated, and the application of topical treatment had not yielded substantial improvement, which led to a state of distress for the patient. She was diagnosed with cheilitis simplex and was subsequently treated with a single subdermal injection of a combination of 1% HA, 1% PN, and 0.3% lidocaine. Lip hydration was increased gradually, as measured by tewameter, with peak rate of hydration (26.218 g/m2/h) occurred two weeks after injection, and subsequently decreased gradually until six weeks after injection (29.926 g/m2/h); however, the rate of hydration remained higher than the baseline value (34.386 g/m2/h). Additionally, the lips exhibited an increase in brightness and a shift in pigmentation toward a rosier hue, as substantiated by spectrophotometric analysis. The mechanism of HA and PN include providing hydration and stimulating dermal fibroblast activity. However, PN may also exert an additional effect of improving lip pigmentation by reducing melanin and increasing hemoglobin levels. In conclusion, the lip booster injection, comprising 1% PN, 1% non-cross-linked HA, and 0.3% lidocaine, is an efficacious and practical treatment option for cheilitis simplex. This treatment option offers the additional benefits of being pain-free and enhancing lip pigmentation. Further studies are required to confirm these findings.Keywords: cheilitis simplex, dry and chapped lips, hyaluronic acid, lip booster, polynucleotide